Too many myths about women and heart disease persist. Here’s the real story on how to stay safe.

Want to know the secret to a healthy heart? It’s got nothing to do with fate and everything to do with the lifestyle decisions we make daily. But too many of us aren’t taking the right steps to protect ourselves: Every year more women will die from cardiovascular disease than from all types of cancer combined. To safeguard your heart and keep it ticking for years to come, top doctors address common misconceptions and set the record straight.

Myth 1: The essential part of a heart-healthy diet is avoiding saturated fat.
Where cardiac trouble is concerned, saturated fat has long been considered public enemy number one, but a 2010 report that reviewed the findings of 21 studies found no conclusive evidence that consuming saturated fat increases a person’s risk of heart disease. The likely culprit: refined carbohydrates. “The high levels of sugar raise insulin levels and after a few hours cause blood sugar to crash, which can make many people crave more processed carbs,” says David Ludwig, MD, PhD, director of the New Balance Foundation Obesity Prevention Center at Boston Children’s Hospital. “The vicious cycle, over time, increases the risk of obesity, heart disease, and diabetes more so than total dietary fat does.” This doesn’t mean you can go crazy with butter and bacon; instead focus on replacing refined starches with vegetables, fruits, and beans—all foods that happen to be low in fat.

Myth 2: I’m in my 20s — I don’t have to worry about heart disease yet.
What Ails You: Wrong! The plaques that eventually lead to clogged arteries can start accumulating during adolescence, which is why cholesterol checks should begin as early as age 20. Even if you’re young, your chances of developing heart disease increase at least tenfold when you have three or more risk factors — for instance, if you smoke, you’re overweight, you don’t exercise, and you’re chronically stressed. “While it’s true that women under 55 make up fewer than 5 percent of all heart disease cases, studies suggest that young women who do have heart attacks are twice as likely to die, compared with young men,” says Judith Lichtman, PhD, an associate professor of epidemiology at Yale’s School of Public Health. While no research has proved why female heart attack patients have a higher mortality rate, some researchers believe that it may be due in part to less aggressive treatment and post-op care.

Myth 3: An aspirin a day keeps heart trouble away.
In truth, the little pill’s effectiveness depends on your age. A study in The New England Journal of Medicine found that for women under age 65, taking 100 milligrams of aspirin every other day did not affect the risk of a heart attack. For women 65 and over, however, it lowered the risk by 34 percent. “Aspirin can have serious side effects, including gastrointestinal bleeding,” says Lori Mosca, MD, PhD, director of preventive cardiology at New York–Presbyterian Hospital in Manhattan. “The benefits may not always outweigh the dangers, especially for younger women.”

Myth 4: Heart disease runs in my family, so I’m doomed.
According to a study in The Lancet, less than 10 percent of heart disease is genetic. And genetic risk factors can vary in importance — some gene variations raise your risk by only around 15 percent, while very rare mutations may increase it by 200 percent or more. “For the vast majority of people, lifestyle choices are a better predictor,” says Suzanne Steinbaum, director of the Women and Heart Disease program at Lenox Hill Hospital in New York City. “When my female patients who have a strong family history take proactive steps to lead healthier lives, virtually none of them develop the disease.”